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Lateral cartilage defects and medial subchondral surface ratio are associated with knee‐related disability
Author(s) -
Everhart Joshua S.,
Abouljoud Moneer M.,
Flanigan David C.
Publication year - 2019
Publication title -
journal of orthopaedic research®
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.041
H-Index - 155
eISSN - 1554-527X
pISSN - 0736-0266
DOI - 10.1002/jor.24187
Subject(s) - osteoarthritis , medicine , womac , confounding , quality of life (healthcare) , physical therapy , radiography , cartilage , surgery , pathology , anatomy , alternative medicine , nursing
We sought to determine the relationship between (i) full‐thickness cartilage defects and tibiofemoral subchondral surface ratio (SSR) and (ii) disability and quality of life in patients with mild radiographic osteoarthritis (OA) (Kellgren‐Lawrence grade 2) or without radiographic OA (Kellgren‐Lawrence grades 0 or 1)? A total of 642 participants from the Osteoarthritis Initiative (OAI) with baseline knee MRIs and a Kellgren‐Lawrence grade 2 or less on both bilateral screening radiographs were included. The independent relationship was assessed between (i) full‐thickness cartilage defect presence and tibiofemoral SSR and (ii) Knee Injury and Osteoarthritis Outcome Score (KOOS) quality of life (QOL), KOOS function in sports and recreation (KOOS‐sport/rec), and Western Ontario and McMaster Universities Arthritis Index (WOMAC) disability score after adjustment for relevant confounders with multivariate regression modeling. The prevalence of medial full‐thickness defects was 10.4% (67/642) and lateral was 18.1% (116/642). Lateral defect presence was associated with worse KOOS‐QOL (beta −3.61 SE 1.04; p = 0.001), KOOS‐sport/rec (beta −4.70 SE 1.38; p = 0.001) and WOMAC‐disability scores (beta 0.02 SE 0.01; p = 0.001); these associations were not influenced by defect size. A larger medial compartment SSR was associated with worse KOOS‐QOL (beta −27.20 SE 6.80; p < 0.001), KOOS‐sports/rec (beta −22.30 SE 9.01; p = 0.01) and WOMAC‐disability scores (beta 0.16 SE 0.04; p < 0.001). In older adults with little to no radiographic osteoarthritis, lateral full‐thickness cartilage defects, irrespective of size, and a larger medial compartment tibiofemoral SSR are potential sources of knee‐related symptoms that are not appreciated on standard radiographs. © 2018 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 37:378–385, 2019.